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Purpose
Sonoelastography (ES) is a new imaging modality that can be combined with sonography and improves its accuracy in many challenging diagnostic situations (1-5). Sonoelastography is recently used for evaluation of many pathologies of superficial organs such as thyroid, breast and prostate etc (1-4 ). However, there is only one report describing elastographic findings of appendicitis in Pubmed (1). Here, free-hand sonoelastographic findings of acute appendicitis will be described.
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Material and Methods
Thirtyfour cases ranged between 17-45 years old (25 male-9 female) suspected of appendicitis and presented with acute right quadrant pain were prospectively evaluated with ultrasonography and additionally with Free-hand sonoelastography using 5-9 Mhz Lineer transducer (Antares-Acuson). Sonographic diagnosis of appendicitis was established using Puylaert’s method ( diameter and wall thickness > 6mm and 3 mm respectively). Sonoelastography was performed by manual compression of ultrasound...
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Results
Diameters and wall thickness of appendix were between 9-18 mm (mean 11.6 mm) and 3-6 mm (mean 4.5 mm) respectively. Variable degrees of decreased elasticity were observed in the wall and lumen of appendix and adjacent fatty tissues. Mean stifness score of wall and lumen and adjacent fatty tissues of appendix were 1.1, 1.1, and 2.9 respectively. Wall scores of Four cases were 0, six cases were 1, five cases were 2, four cases were 3, five cases were 4. presence of red color in the lumen of...
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Conclusion
Appendicitis is usually radiologically evaluated with US and CT in most cases in daily practice. However differentiaton of perforated and nonperforated cases may be a problem. Elastography may help in this situation. Demonstration of "ring pattern" is always observed in nonperforated cases in our limited series. Moreover, we believe elastography is the most effective radiological method revealing inflammation of mesenteric periappendicial fatty tissue. Elastography is very sensitive to reveal...
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References
1. Ginat DT, Destounis SV, Barr RG, Castaneda B, Strang JG, Rubens DJ, Elastography of Breast and Prostate Lesions RadioGraphics 2009; 29: 2007 –2016 2. Garra BS, Cespedes EI, Ophir J, et al. Elastography of breast lesions: initial clinical results. Radiology 1997;202(1):79–86. 3. Pallwein L, Mitterberger M, Pinggera G, et al. Sonoelastography of the prostate: comparison with systematic biopsy findings in 492 patients. Eur J Radiol 2008;65(2):304–310 4. Garra BS, Elastography: Current Status,...
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Author Information
Gökhan Pekindil, MD, prof in Radiology, abdominal imaging, Celal Bayar university School of medicine Manisa-Turkey e-mail:pekindilg@yahoo.com